R S Rocha

Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil

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Publications (71)143.43 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The influence of nutritional status and hormonal growth activity on the impaired somatic development of adolescents with the hepatosplenic clinical form of Schistosoma mansoni infection (HS), the intestinal form with high (IH) or low (IL) egg output and non-infected (NI) individuals was evaluated (in Comercinho, Minas Gerais State, Brazil, in 1996-97) by measuring body mass index (BMI), insulin-like growth promoting factor (IGF-I) and its carrier protein (IGFBP-3). BMI, IGF-I and IGFBP-3 concentrations were significantly lower in the HS group compared with the IH and the NI groups, irrespective of age. BMI did not remain associated with the clinical form in the bi-variate model that included IGF-I and BMI or IGFBP-3 and BMI, suggesting that in these groups IGF-I and IGFBP-3 levels were related to the clinical form but independent of nutritional status. It is suggested that physical growth impairment in hepatosplenic S. mansoni infection results from the synergistic action of both hepatic damage and nutritional restriction.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2001; 95(4):453-6. · 1.82 Impact Factor
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    Revista da Sociedade Brasileira de Medicina Tropical 10/2000; 33(5):431-436. · 0.93 Impact Factor
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    ABSTRACT: The use of questionnaires has been recommended for identifying, at a lower cost, individuals at risk for schistosomiasis. In this study, validity of information obtained by questionnaire in the screening for Schistosoma mansoni infection was assessed in four communities in the State of Minas Gerais, Brazil. Explanatory variables were water contact activities, sociodemographic characteristics and previous treatment for schistosomiasis. From 677, 1474, 766 and 3290 individuals eligible for stool examination in the communities, 89 to 97% participated in the study. The estimated probability of individuals to be infected, if they have all characteristics identified as independently associated with S.mansoni infection, varied from 15% in Canabrava, to 42% in Belo Horizonte, 48% in Comercinho and 80% in São José do Acácio. Our results do not support the hypothesis that a same questionnaire on risk factors could be used in screening for S.mansoni infection in different communities.
    Revista do Instituto de Medicina Tropical de São Paulo 01/1998; 40(2):93-9. · 0.96 Impact Factor
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    ABSTRACT: Giardiasis is a cosmopolitan parasitosis. Diarrhea, abdominal colic, and flatulence are the main clinical symptoms, however, malabsorption, and impairment of growth of children may occur. The 5-nitroimidazoles are the drugs of choice in the treatment of giardiasis. Methods: The efficacy and tolerability of secnidazole and tinidazole were evaluated in a randomized, open-label, clinical trial performed with 267 Giardia lamblia-positive children. Secnidazole, in a new gel formulation, and tinidazole suspension were prescribed as single oral doses of 30mg/kg and 50mg/kg, respectively. Clinical and parasitological follow-up was carried out before, and at 7, 14, and 21 days after treatment. Results: Clinical cure was observed in 77.3% and 75.7% of the patients in the secnidazole and tinidazole groups, respectively. Parasitological cure was obtained in the 91.3% and 89.6% in the secnidazole and tinidazole groups, respectively. A metallic taste after drug ingestion was more commonly reported in the tinidazole group than in the secnidazole group (p<0.05). Conclusions: The authors conclude that both secnidazole gel and tinidazole administered as a single oral dose are effective treatments for children with giardiasis since both high cure rates and good tolerability were observed.
    The Brazilian journal of infectious diseases: an official publication of the Brazilian Society of Infectious Diseases 11/1997; 1(5):241-247. · 1.04 Impact Factor
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    ABSTRACT: Eighteen patients with acute Schistosoma mansoni infection were followed up for 2 years after treatment with praziquantel or oxamniquine. Cure rates, clinical features, abdominal ultrasonographic findings, and specific humoral responses were determined at 2-, 6-, and 24-month follow-ups. Fourteen patients (77.8%) were considered parasitologically cured. Levels of IgA antibody to soluble egg antigen (SEA) and IgM antibody to keyhole limpet hemocyanin (KLH) became negative or decreased to the cutoff level for chronic infection 2 months after treatment, while levels of IgG antibody to KLH declined between 12 and 24 months after treatment. Levels of IgM and IgG antibodies to saline worm adult protein as well as IgM and IgG antibodies to SEA remained positive during the follow-up period. Discrete lymph node enlargement and hepatomegaly were still present in six of the eight cured children 2 years after treatment, while complete regression was observed in adults. In our group of patients, in addition to presenting with more intense clinical manifestations, children were cured less often and had slower abatement of symptomatology after treatment than adults.
    Clinical Infectious Diseases 04/1997; 24(3):304-8. · 9.37 Impact Factor
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    ABSTRACT: Schistosomiasis (Schistosoma mansoni) is classically described as a rural disease that occurs in areas with poor sanitary conditions. This cross-sectional study was undertaken in a suburban area of a large industrialized city in Brazil (Belo Horizonte), aiming at examining epidemiological characteristics of schistosomiasis in an urban setting. A simple random sample of 658/1896 dwellings was selected and 3049/3290 (92.7%) residents were submitted to stool examination. Of 518 eligible infected cases and 518 uninfected controls, 87.1% and 89.9% participated in the study, respectively. The prevalence of S. mansoni infection was 20%, predominantly low egg counts in stools; no cases of splenomegaly were found. Signs and symptoms associated with infection were bloody stools (odds ratio [OR] = 8.0) and hardened palpable liver at the middle clavicular and at the middle sternal life (OR = 5.5 and 8.0 respectively). Sociodemographic variables and water contacts predictive of infection were age (10-19 and > or = 20 yrs; OR = 7.1 and 3.3, respectively), gender (male; OR = 3.1), contacts for swimming and/or playing (twice a month or less and more than twice a month; OR = 2.2 and 3.0, respectively) and residence in Belo Horizonte (born in the City; OR = 2.5). Ninety per cent of dwellings had a piped water supply; no association between water supply and infection was found. Our results emphasize the need for schistosomiasis control measures focusing on water contacts for leisure purposes in this industrialized urban area.
    International Journal of Epidemiology 12/1996; 25(6):1292-300. · 6.98 Impact Factor
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    ABSTRACT: A clinical study of 34 previously healthy young patients simultaneously infected in an endemic area of schistosomiasis mansoni is presented, emphasizing the initial phase of the infection. Its intensity was established according to the occurrence, intensity, and duration of the signs and symptoms in order to investigate the possible correlations between the worm burden (estimated by the number of eggs in faeces), the blood eosinophilia and specific levels of IgE (estimated by the area of immediate intradermal reaction), with the clinical manifestations. A significant but low-level association was found between the worm burden and morbidity, suggesting that multiple factors, besides worm burden itself, may contribute to the pathogenesis of the disease.
    Tropical Medicine & International Health 05/1996; 1(2):213-20. · 2.94 Impact Factor
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    ABSTRACT: In this study, the results obtained in a control programme of schistosomiasis in Ravena (Sabará, Minas Gerais) between 1980 and 1992 are evaluated. Control measures used in this programme were: specific treatment of the people infected with Schistosoma mansoni at four year-intervals (1980/84/88) and the supply of tap water to 90% of the residences in 1980. A significant reduction of the prevalence (36.7% to 11.5%, p < or = 0.05) and of the intensity of the infection (228.9 eggs per gram of feces (epg), s = 3.7 to 60.3 epg, s = 3.5, p < or = 0.05) was observed. No cases of the severe form of the disease were diagnosed in the area. Factors independently associated with the infection were in 1980 daily sand extraction and the lack of tap water in residences and in 1992 daily sand extraction and fishing and weekly swimming. Concluding, the supply of tap water together with quadrennial treatments significantly diminished both the prevalence and intensity of the S. mansoni infection, with the additional gain of persistent low indices even after four-year intervals between the treatments.
    Memórias do Instituto Oswaldo Cruz 01/1996; 91(6):659-64. · 1.36 Impact Factor
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    ABSTRACT: An analysis of 25 individuals simultaneously exposed to cercariae of Schistosoma mansoni showed that morbidity (measured by the clinical/sonographic index) was more severe in patients with high-level egg output, irrespective of age or intensity of water contact. High levels of IgM and IgG antibodies to keyhole limpet hemocyanin and of IgA antibody to soluble egg antigen were documented predominantly during the acute phase of illness. Increased levels of these antibodies and of IgM antibody to soluble egg antigen correlated positively with morbidity after adjustment for age and intensity of water contact.
    Clinical Infectious Diseases 10/1995; 21(3):608-15. · 9.37 Impact Factor
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    ABSTRACT: The effect of the colour group on the morbidity due to Schistosoma mansoni was examined in two endemic areas situated in the State of Minas Gerais, Brazil. Of the 2773 eligible inhabitants, 1971 (71.1%) participated in the study: 545 (27.6%) were classified as white, 719 (36.5%) as intermediate and 707 (35.9%) as black. For each colour group, signs and symptoms of individuals who eliminated S.mansoni eggs (cases) were compared to those who did not present eggs in the faeces (controls). The odds ratios were adjusted by age, gender, previous treatment for schistosomiasis, endemic area and quality of the household. There was no evidence of a modifier effect of colour on diarrhea, bloody faeces or abdominal pain. A modifier effect of colour on hepatomegaly was evident among those heaviest infected (> or = 400 epg): the adjusted odds ratios for palpable liver at the middle clavicular and the middle sternal lines were smaller among blacks (5.4 and 6.5, respectively) and higher among whites (10.6 and 12.9) and intermediates (10.4 and 10.1, respectively). These results point out the existence of some degree of protection against hepatomegaly among blacks heaviest infected in the studied areas.
    Revista do Instituto de Medicina Tropical de São Paulo 01/1995; 37(6):493-500. · 0.96 Impact Factor
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    ABSTRACT: The clinical and radiological pulmonary manifestations in the initial phase of schistosomiasis mansoni were studied in thirty previously healthy individuals who were simultaneously infected. The findings were compared with those concerning a control group and related to possible pathogenetic factors. The respiratory manifestations were of light or of moderate intensity, the dry cough being the most common symptom. The significant radiological alterations were: thickening of bronchial walls and beaded micronodulation, predominantly localized in the lower pulmonary fields. It was observed significant association between wheezing and IgE levels, estimated by the area of immediate intradermal reaction, as well as between the number of blood eosinophils and the occurrence of radiological changes. Moreover, there was correlation between the worm burden and the presence of wheezing, thoracic pain and beaded micronodulation. Thus, the clinical and radiological pulmonary manifestations described are significant part of the initial phase of schistosomiasis mansoni and present the worm burden, eosinophilia and levels of IgE as probable pathogenetic factors.
    Revista do Instituto de Medicina Tropical de São Paulo 01/1995; 37(4):311-8. · 0.96 Impact Factor
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    ABSTRACT: Abdominal ultrasonography was performed on eight children and four adults with acute schistosomiasis mansoni, 12 chronically infected patients, and 12 noninfected individuals from the endemic area, who were paired by age and sex with the acute group. In all acute patients, lymphadenomegaly as well as liver and spleen enlargement were detected. Lymph nodes surrounding the portal vein and the hepatic artery in the hepatic hilus were visualized. In the children, the right lobe of the liver was statistically significantly larger in the acute group than in the noninfected group. The portal and splenic vein diameters were significantly larger in children with acute schistosomiasis than in the chronically infected and negative control groups. The left hepatic lobe and a longitudinal scan of the spleen in acute adult patients were statistically significantly larger than in the chronically infected and negative control groups. Ultrasonography is shown to be a useful tool for the differential diagnosis of acute schistosomiasis mansoni.
    The American journal of tropical medicine and hygiene 07/1994; 50(6):748-52. · 2.53 Impact Factor
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    ABSTRACT: A study of factors associated with the hepatosplenic clinical form of schistosomiasis was carried out in an endemic area (Comercinho, Minas Gerais) where prevalence of Schistosoma mansoni infection was 70.4%. Of the 1,408 inhabitants aged two years and over, 1,162 (82.5%) participated in the study. Socio-demographic characteristics and reasons for water contacts of individuals with the hepatosplenic form (n = 73) were compared to those who did not present splenomegaly and eliminated (positive controls; n + 804) or did not eliminate S. mansoni eggs in stools (negative controls; n = 285). Multivariate analysis was performed, considering the existence of colinearity among socio-economic status of the family, running water in the household, and bathing in streams. The hepatosplenic form in children was strongly associated with occupation of the head of the family (manual workers) (OR = 11.4; 95% CI = 1.4 - 91.8), absence of running water in the household (OR = 7.7; 95% CI = 2.6 - 23.1), and bathing in streams (OR and 95% CI 7.6; 2.5-22.9 and 5.7; 1.3-25.5 for frequencies > weekly and <= weekly, respectively); bathing in streams, which implies intense contacts, was a consequence of the first two factors. Our results suggest that running water in the household can decrease morbidity from schistosomiasis because it reduces the need for intense contacts with streams.
    Cadernos de Saúde Pública 02/1994; 10 Suppl 2:241-53. · 0.83 Impact Factor
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    ABSTRACT: A fourteen year schistosomiasis control program in Peri-Peri (Capim Branco, MG) reduced prevalence from 43.5 to 4.4%; incidence from 19.0 to 2.9%, the geometric mean of the number of eggs from 281 to 87 and the level of the hepatoesplenic form cases from 5.9 to 0.0%. In 1991, three years after the interruption of the program, the prevalence had risen to 19.6%. The district consists of Barbosa (a rural area) and Peri-Peri itself (an urban area). In 1991, the prevalence in the two areas was 28.4% and 16.0% respectively. A multivariate analysis of risk factors for schistosomiasis indicated the domestic agricultural activity with population attributive risk (PAR) of 29.82%, the distance (< 10m) from home to water source (PAR = 25.93%) and weekly fishing (PAR = 17.21%) as being responsible for infections in the rural area. The recommended control measures for this area are non-manual irrigation and removal of homes to more than ten meters from irrigation ditches. In the urban area, it was observed that swimming at weekly intervals (PAR = 20.71%), daily domestic agricultural activity (PAR = 4.07%) and the absence of drinking water in the home (PAR = 4.29%) were responsible for infections. Thus, in the urban area the recommended control measures are the substitution of manual irrigation with an irrigation method that avoids contact with water, the creation of leisure options of the population and the provision of a domestic water supply.(ABSTRACT TRUNCATED AT 250 WORDS)
    Revista do Instituto de Medicina Tropical de São Paulo 01/1994; 36(3):245-53. · 0.96 Impact Factor
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    ABSTRACT: The incidences of Schistosoma mansoni infection and reinfection were investigated in an endemic area of Brazil (Peri-Peri, State of Minas Gerais) where chemotherapy and snail control had been used for 13 years (1974-87). Two cohorts were followed: the first consisted of 584 individuals with no evidence of infection at entry (infection cohort), and the second comprised 296 individuals who were treated and did not eliminate eggs 8-12 months afterwards (reinfection cohort). The incidence of infection (per 100 person-years) decreased from 7.5 in 1974-77 to 3.6 in 1986-87, and that of reinfection from 21.3 in 1974-77 to 3.7 in 1986-87. Calendar period, age at risk, and sex were independently associated with both infection and reinfection, while a heavy S. mansoni egg count prior to treatment (> or = 500 epg (eggs per gram of stools)) was independently associated with reinfection. The geometric mean number of eggs after treatment among those reinfected (47 epg) was approximately half that among those infected for the first time (81.5 epg). Age at risk had the greatest effect on both infection and reinfection. The rate ratios of infection and reinfection were 3 to 6 times higher among individuals younger than 20 years than among those aged > or = 25 years, even after adjusting for confounders. This suggests the existence of a strong protective effect with increased age (because of biological and/or environmental factors) for both infection and reinfection.
    Bulletin of the World Health Organisation 02/1993; 71(2):197-205. · 5.25 Impact Factor
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    ABSTRACT: In this paper the history of 115 recruits that had bathed simultaneously in streams contaminated with Schistosoma mansoni, during military maneuvers, is reported. Thirty four of the infected patients presented the initial phase of the infection diagnosed through epidemiologic, clinical and laboratory parameters. Three out of the 34 patients did not reveal the clinical picture of the infection, thus being considered representatives of the non-apparent form of the disease. Differences between the intensity of blood eosinophilia, the area of immediate cutaneous reaction and the number of Schistosoma eggs eliminated in the stools proved not to be statistically significant (p > 0.05) when the non-apparent and acute cases of schistosomiasis were compared. These cases actually may be considered evidences of the non-apparent form hitherto merely taken for granted in the literature.
    Revista do Instituto de Medicina Tropical de São Paulo 01/1993; 35(3):247-51. · 0.96 Impact Factor
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    ABSTRACT: Two immunoassays, dot enzyme-linked immunosorbent assay (dot-ELISA) and dot-dye immunoassay (dot-DIA), using soluble egg antigen and keyhole limpet haemocyanin as antigens, were evaluated for the serological differentiation of 25 acute and 37 chronic patients infected with Schistosoma mansoni and 20 non-infected individuals, in comparison with ELISA. Efficiency was 92.7%, 90.0% for ELISA, dot-ELISA and dot-DIA, respectively. Dipstick dot-ELISA and dot-DIA are described and shown to be reliable cheap and simple methods for the serological differentiation of acute and chronic schistosomiasis.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/1993; 87(3):279-81. · 1.82 Impact Factor
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    ABSTRACT: Antibody (immunoglobulin (Ig) G) to the haemocyanin of the keyhole limpet (KLH) (Megathura crenulata), which shares a well defined carbohydrate epitope with the surface of schistosomula of Schistosoma mansoni, was determined by enzyme-linked immunosorbent assay (ELISA) in the sera of Brazilians with acute schistosomiasis. Of 53 such individuals tested, 51 had a level of KLH reactivity in excess of the mean +2 standard deviations of that exhibited by chronically infected individuals. This difference in reactivity allowed the acute cases to be readily identified by visual inspection of ELISA plates. The levels of IgG in patients with hepatointestinal and hepatosplenic schistosomiasis, as well as in non-infected, seropositive residents of endemic areas and infected children from endemic areas, were not statistically different from those of intestinal patients. Significant levels of anti-KLH IgG were not detected in patients with leishmaniasis, Chagas disease, ancylostomiasis or ascariasis. The results support the use of KLH as a means of rapidly and easily identifying individuals with acute schistosomiasis.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/1992; 86(1):53-6. · 1.82 Impact Factor
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    ABSTRACT: A schistosomiasis control program was implemented between 1974/87 in Peri-Peri, MG (622 inhabitants). Molluscicide (niclosamide) was applied at three monthly intervals in water sources with Biomphalaria glabrata, and individuals eliminating Schistosoma mansoni eggs in the feces were treated annually with oxamniquine. From 1974 to 1983 the control measures were undertaken by staff of the "René Rachou" Research Center FIOCRUZ (CPqRR), and from 1984 to 1987 these measures were included in the Capim Branco basic health network activities. During both periods, the prevalence, incidence, intensity of infection and hepatosplenic form as well as the number of infected snails decreased significantly. The prevalence decreased from 43.5 to 4.4%, the incidence from 19.0 to 2.9%, the overall intensity of S. mansoni from 281 to 87 and of the hepatosplenic form from 5.9 to 0.0%. The results obtained suggest that the municipal management of control measures was as effective as the vertical program conducted by CPqRR staff.
    Revista do Instituto de Medicina Tropical de São Paulo 01/1992; 34(6):543-8. · 0.96 Impact Factor
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    ABSTRACT: From each of a group of 217 adult males selected through enzyme-immunoassay or skin-test (Group A), six stool samples were examined by both the Lutz/Hoffman, Pons & Janer (Lutz/HPJ) and Kato/Katz methods. In addition, one oogram of the rectal mucosa was performed. By these methods, schistosomiasis was detected in 44.7%, 47.5% and 40.1% of the individuals respectively. To evaluate the methods in the assessment of cure, the last 40 patients from group A, treated with a single oral dose of oxamniquine at 15 mg/kg were followed up for six months (Group B). The criteria for parasitological cure included three stool examinations by Kato/Katz and Lutz/HPJ methods, one, three and six months post-treatment and a rectal biopsy between the fourth and sixth months post-treatment. The examinations were negative in 87.5%, 90% and 95% of the patients, respectively. The efficacy of oxamniquine was 82.5% when the three methods were considered together and there was no statistically significant difference between the sensitivity of the individual methods.
    Revista do Instituto de Medicina Tropical de São Paulo 01/1992; 34(6):601-8. · 0.96 Impact Factor

Publication Stats

596 Citations
143.43 Total Impact Points

Institutions

  • 1981–2000
    • Fundação Oswaldo Cruz
      • Centro de Pesquisas René Rachou (CPqRR) - Fiocruz Minas
      Rio de Janeiro, Rio de Janeiro, Brazil
  • 1997
    • Universidade de Mogi das Cruzes
      Moji das Cruzes, São Paulo, Brazil
  • 1987–1996
    • Unimed Belo Horizonte
      Cidade de Minas, Minas Gerais, Brazil
  • 1988–1994
    • Federal University of Minas Gerais
      • Departamento de Medicina Preventiva e Social
      Belo Horizonte, Estado de Minas Gerais, Brazil
  • 1986
    • Vanderbilt University
      Nashville, Michigan, United States